Snapshot A 35-year-old G1P0 woman is in the labor and delivery unit and has been in labor for the past 6 hours. Her pregnancy was significant for gestational diabetes. The woman elected to have epidural anesthesia during labor, and forceps are used to aid delivery of her baby. The obstetrician examines the woman's vagina and perineum after the delivery, and notes she has a third-degree perineal laceration. Introduction Overview perineal lacerations are lacerations associated with vaginal childbirth that may occur when the vagina and surrounding tissues stretch during delivery login to view 8 more bullets Epidemiology > 85% of women who undergo a vaginal delivey will suffer some degree of perineal tear 3-10% of all vaginal deliveries result in a 3rd-degree or 4th-degree tear Risk factors forceps delivery nulliparity large for gestational age or birthweight longer duration of 2nd stage of labor ETIOLOGY Pathophysiology mechanism of injury login to view 1 more bullet Presentation Symptoms perineal pain login to view 1 more bullet Physical exam laceration of the perineum and surrounding tissue, closed by sutures Treatment Surgical closure of laceration with sutures login to view 1 more bullet anal sphincter and mucosa repair login to view 1 more bullet Complications Perineal wound dehiscence incidence login to view 1 more bullet Perineal wound infection incidence login to view 1 more bullet